Cancer prevention through physical activity and diet: an updated guideline from the U.S.

Cristina Ferrario

According to the latest update of the American Cancer Society (ACS) guideline, four main pillars are needed to keep cancer away using diet and exercise. Here they are: achieve and maintain a healthy body weight throughout life, be physically active, follow a healthy eating pattern at all ages, and it is best not to drink alcohol. “The ACS guideline focuses on recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or creates barriers to healthy behaviours. Therefore, this committee presents recommendations for community action to accompany the 4 recommendations for individual choices to reduce cancer risk” authors wrote in the paper published on CA: A Cancer Journal for Clinicians, updating the 2012 release of ACS Guideline for Diet and Physical Activity for Cancer Prevention.

As reported by ACS experts, the new recommendations are based on the most recent evidence related to the impact of diet and activity patterns on cancer prevention. “[They] are based largely on the WCRF/AICR systematic reviews and Continuous Update Project reports, supplemented with evidence from systematic reviews and large pooled analyses that have been published since the most recent WCRF/AICR reports” authors pointed out, highlighting that most of the evidence in the field derives from observational epidemiological studies, with all the limitations link to this kind of assessment. Nonetheless, the updated ACS guideline is consistent with guidelines from other important association/institutions such as the US Department of Health and Human Services (USDHSS; Dietary Guidelines for Americans and Physical Activity Guidelines for Americans), and the Centers for Disease Control and Prevention (CDC).

Back to the four pillars, ACS experts raised the bar of the recommended physical activity compared to the previous release, while keeping on focusing on dietary patterns in contrast to individual compounds or nutrients, an approach defined as “more consistent with what and how people actually eat”.

Going deeper into details, in the new guidelines 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity physical activity per week are recommended for adults, underlining that “achieving or exceeding the upper limit of 300 minutes is optimal”. As for diet, a plant-based diet is recommended, full of fibres legumes, colourful fruit and vegetables and whole grains and with only small amounts, if any, of red meat, processed foods and sugar-sweetened beverages. An increased emphasis on reducing the consumption of alcohol is also present in the 2020 release of the ACS Guideline: “It is best not to drink alcohol” expert stated.

Last but not least, ACS experts recognized that individual choices towards a healthy diet and behaviour are strongly influenced by social, economic, and cultural factors. “The ability of an individual to avoid many unhealthy lifestyle factors, including those related to food and beverage intake and physical inactivity, is often influenced by factors outside of his or her direct control” they said. Starting from this idea, a new recommendation for Community Action has been included stating that: “Public, private, and community organizations should work collaboratively at national, state, and local levels to develop, advocate for, and implement policy and environmental changes that increase access to affordable, nutritious foods; provide safe, enjoyable, and accessible opportunities for physical activity; and limit access to alcoholic beverages for all individuals”.

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